CN101267774A - A surgical drill, a set of surgical drills, a system for cutting bone and a method for removing bone - Google Patents

A surgical drill, a set of surgical drills, a system for cutting bone and a method for removing bone Download PDF

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CN101267774A
CN101267774A CN 200680034944 CN200680034944A CN101267774A CN 101267774 A CN101267774 A CN 101267774A CN 200680034944 CN200680034944 CN 200680034944 CN 200680034944 A CN200680034944 A CN 200680034944A CN 101267774 A CN101267774 A CN 101267774A
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cutting
drill
surgical
mm
non
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CN 200680034944
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Chinese (zh)
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CN101267774B (en
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霍格兰德·托马斯
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霍格兰德·托马斯
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Priority to GB0519459.2 priority Critical
Priority to GB0519459A priority patent/GB2430396A/en
Application filed by 霍格兰德·托马斯 filed Critical 霍格兰德·托马斯
Priority to PCT/EP2006/009227 priority patent/WO2007039141A2/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613Component parts
    • A61B17/1615Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A61B17/1617Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1671Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613Component parts
    • A61B17/1633Sleeves, i.e. non-rotating parts surrounding the bit shaft, e.g. the sleeve forming a single unit with the bit shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/164Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans intramedullary
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1695Trepans or craniotomes, i.e. specially adapted for drilling thin bones such as the skull
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1697Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans specially adapted for wire insertion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1757Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1796Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation

Abstract

The present invention relates to a surgical drill including a drill member having a cutting section for cutting bone, the cutting section being situated at a distal end of the drill member. The drill member also comprises a non-cutting protection tip for protecting nerves, tissue or dura from being cut. The non-cutting protection tip is situated distally of the cutting section.

Description

手术钻头、手术钻头组、用于切割骨骼的系统以及移除骨骼的方法技术领域本发明涉及一种如权利要求1前序部分所述的手术钻头、手术钻头组、用于切割骨骼的系统以及移除骨骼的方法。 Surgical drill bit set operation, a system FIELD bone cutting and removing bone present invention relates to a surgical drill according to the preamble of claim 1, bit set operation, a system for cutting bone and the method of bone removed. 在脊柱手术领域中,需要通过采用背面或后外侧的操作,来移除小关节的部分以及小关节嚢,使脊柱内的结构暴露出来。 In the field of spinal surgery, the need to use or after operation of the outside of the back surface, the facet joint is removed and a small portion of the joint Nang the intraspinal structures exposed. 对脊推的部分骨骼结构实施的移除是为了接近充有神经组织的脊推管。 Removing a portion of the embodiment of the bone structure of the spine is pushed close to charged with spinal nerve tissue push tube. 在脊推管内的神经組织的组织结构很脆弱,具有树状构造,即脊推管的中央部分充有一个由神经纤维组成的长条(硬脑膜)。 Structure of nerve tissue in the spine of the push tube is fragile, has a tree structure, i.e. the central portion of the push tube is filled with a ridge strip (dura) consisting of nerve fibers. 从这个充满神经的长条,神经根在脊推骨间的水平出现向左和向右的分支,而神经根通过两侧的通道、孔离开脊推管。 From this full of long nerve, nerve roots appear in the left and right branch between the horizontal ridges push the bone, and nerve roots leaving the spinal channel through the sides of the hole push tube. 在人体内,包括神经纤维的硬脑膜长条及其分支可以在病理上通过下列情形被压缩在脊推管的水平,或者在是孔(通道)内:-1.推间盘部分突出或#:挤出2. 小关节肥大3. 小关节嚢肥大4. 小关节的滑液嚢肿5. 推管内肿瘤或6. 推间盘塌陷,可能导致孔的缩小。 In the human body, comprising an elongated dural nerve fibers and its branches can be horizontally compressed by the ridge of the push tube in the following pathological situations, or in a bore (channel): intervertebral disc or portion projecting # -1 : 2. extrusion 3. facet joint hypertrophy Nang facet joint inner mast 4. the facet joint synovial swelling Nang tumor or 6. 5. the push tube between the push plate collapse, may lead to a reduction hole. 这种硬脑膜长条以及硬脑膜长条内的分别的神经纤维的压缩造成病人的疼痛、麻木甚至瘫痪。 Such long dura and nerve fibers are compressed within the dura mater of the patient causing pain strip, numbness or even paralysis. 最常见的并发症是推间盘突出。 The most common complication is pushing disc herniation. 要接近脊推管,以便治疗或移除病变组织,需要移除周围的骨骼部分。 To close the ridge push tube, in order to treat or remove diseased tissue, it is necessary to remove part of the bone around it. 通过移除部分小关节嚢及部分小关节骨骼,能够产生直径为6至11毫米的开口,这样可以插入一支工作插管。 Nang by removing part of the facet joint and part of the small joints of the skeleton, it is possible to produce 6-11 mm diameter opening such that the cannula can be inserted into a work. 通过这个工作插管,外科医生可以对病变推间组织进行操作,举例来说,可以使用标准器械,比如抓紧器、刮匙、铰刀、激光等移除这一组织。 , Through which the surgeon can work cannula diseased tissue between the push operation, for example, using standard equipment, such as graspers, curettes, reamers, laser or the like to remove this tissue. 通过这样一支工作插管,也可以进行盘间空间的清理,在必要时可以插入盘间间隔器或笼状物。 It may be performed by cleaning the disc space between such a working cannula, when necessary, may be inserted between the disc spacer or cage. 在工作插管存在时,清除脊推管内的病理结构的操作可以进一步借助于内窥镜。 In operation the presence of the cannula, removal operation pathological structure within the ridges may further push tube by means of an endoscope. 这种手术通常在二维X光图像增强器的控制下进行。 Such surgery is usually performed under control of a two-dimensional X-ray image intensifier. 去除骨骼结构以接近脊推管,是一个非常精密和壽文感的程序。 Remove bone structure close to the ridge push tube, it is a very sophisticated sense of culture and life of the program. 它必须避免伤害或切断任何神经条(nerve sack)(硬脑膜)或任何神经根分支,因为这种伤害是非常危险的,病人可能无法恢复。 It must avoid any nerve damage or cut off pieces (nerve sack) (dura) or any branch of the nerve root, because such injuries can be very dangerous, the patient may not recover. 打开脊推管的标准程序一直使用手术钻头或4先刀在小关节嚢和/或小关节产生一个开口,以打开脊推管。 Open standard procedure spinal surgery has been used to push drill pipe or first knife 4 Nang facet joint and / or the facet joint to provide an opening to push open the spinal canal. 这些钻头都必须先进并且极为精细,以不伤害甚至割断脊推管内的组织结构。 These drills have to be very advanced and sophisticated, even cut off so as not to harm the organizational structure within the spinal push tube. 美国专,US5931841披露了用于整形外科的钻孔器-铰刀组合。 U.S. Patent, US5931841 discloses a drill for plastic surgery - reamer combination. 美国专利US6443956 4皮露了脊推钻头和插入件。 U.S. Patent US6443956 4 skin exposed ridges and the drill insert push. 发明内容因此,本发明的目的是提供一种手术钻头和一种用于移除骨骼的系统,通过保护脊推内组织,增加可靠性。 SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide a surgical drill and a system for removing bone through the protective ridge interpolation tissue, increase reliability. 这个目的通过权利要求1所述的手术钻头来实现,其中包括具有用于切割骨骼的切割部的钻头元件,所述切割部位于钻头元件的远端。 This object is achieved by surgical drill according to claim 1 is achieved, including a drill bit having a cutting element for cutting bone portion, the drill bit at a distal end portion of the cutting element. 所述钻头元件包括一个非切割保护端,所述非切割保护端保护神经、组织和硬脑膜不被切断, 所述非切割保护端位于钻头元件的切割部的远端。 The drill member comprises a non-cutting protective tip, the protective non-cutting protective tip nerves, tissue and dura are not cut off, the non-cutting protective tip at the distal end portion of the cutting element of the drill bit. 由于非切割保护端的存在, 在切割过程中保护了神经、组织和硬脑膜。 Because of the non-cutting protective tip, protecting nerves, tissue and dura during the cutting process. 由于保护部不进行切割,与脊推管内的神经结构、组织或硬脑膜的任何接触只导致各个软组织的移动。 Since the protective portion does not cut within the neural configuration, the ridge push tube, in contact with any tissue or dura only results in movement of the respective soft tissue. 由于有非切割保护端,可以可靠地排除切断或受伤脊推管内脆弱的软组织。 Because non-cutting end protection can be reliably excluded cut or injured soft tissue in the spine vulnerable push tube. 本发明中的术语"远"与"近"通常指它们与手术器械的关系,"远"指手术器械在被使用时远离外科医生的一端,而"近"指手术器械在被使用时靠近外科医生的一端。 The terms in the present invention, "distal" and "proximal" generally refers to the relationship thereof with the surgical instrument, a "distal" refers to a surgical instrument end remote from the surgeon when used, while "proximal" refers to the surgical instrument closer surgery when used One end of a doctor. 换句话说,远端是手术器械首先插入到病人体内的一端,并通常是操作手术部位的一端,而近端在外科医生的手中。 In other words, the distal end of the surgical instrument is first inserted into one end of a patient, and usually one end of the operation of the surgical site, while the proximal end of the hands of the surgeon. 在手术钻头的一个优选的实施例中,所述切割部具有第一外直径,所述非切割保护端具有小于所述切割部的所述第一外直径的第二外直径。 In a preferred embodiment of a surgical drill, the cutting portion having a first outer diameter, said second non-cutting protective tip having an outer diameter smaller than the outer diameter of the first portion of the cutting. 换句话说, 所述非切割保护端的直径小于所述切割部的直径。 In other words, the non-cutting protective tip diameter smaller than a diameter of the cutting portion. 在优选的实施例中,直径的差为1毫米至2毫米。 In a preferred embodiment, the difference in diameter of 1-2 mm. 这一优选实施例的优点在于,所述非切割保护端可以被插入到引导通道或在使用目前的手术钻头前已经由先前的钻孔装置钻出的其他通道。 Advantage of this preferred embodiment is that the non-cutting protective tip can be inserted into the guide channel or prior to use current surgical drill has drilled the other channel by a previous drilling device. 因此,非切割保护端不只是为了保护脊推管内的脆弱软组织,还可以作为一个引导装置,引导手术钻头沿着先前钻出的引导通道的方向切割骨骼。 Thus, the non-cutting protective tip is not just to protect the vulnerable soft tissue ridges push tube, it can also serve as a guiding means to guide the surgical drill in the direction of the bone cutting guide channel previously drilled. 这带来的优点是采用本手术钻头的切割程序容易进行,这是因为外科医生可以完全专注于钻头的压力和钻孔的速度,不需要集中于对准中心、调节角度及对准钻头。 This brings the advantage of this procedure is the use of surgical cutting bit easy, since the surgeon can completely focus on the pressure and velocity of the drill bit, it does not need to concentrate on centering, aligning and adjusting the angle of the drill bit. 此外,如下面的手术钻头组和手术钻头系统所述,^使用这样的钻头便于扩展已经存在的钻孔通道,可以经过多个钻孔步骤达到所需的直径。 Furthermore, surgical drill bit group and the surgical system described below, use of such a drill ^ scalable existing drilled channel may pass through a plurality of steps to achieve the desired diameter of the borehole. 在一个优选实施例中,所述手术钻头的所述非切割保护端包括至少一个圆柱部和至少一个位于所述圆柱部远端的圆锥部。 In a preferred embodiment, the surgical drill the protective non-cutting end comprises at least one cylindrical portion and a conical portion at least at the distal end of the cylindrical portion. 在进一步的优选实施例中,所述非切割保护端包括至少一个位于圆锥部远端的球形部。 In a further preferred embodiment, the non-cutting protection comprises at least one conical end portion of the distal end of the spherical portion. 所述圓柱部有利于所漆手术钻头的轴的良好定心,而所述圓锥部有助于将所述非切割保护端插入骨骼结构中已经钻好的通道。 Said cylindrical shaft portion of the paint facilitate surgical drill good centering of the conical portion and the non-cutting helps to protect the end structure has been inserted into the drilled bone channel. 这一实施方式能够使外科医生相对于已经存在的通道可靠地插入所述手术钻头并定心。 This embodiment enables the surgeon with respect to the existing channels of the surgical drill reliably inserted and centered. 所述非切割保护端的所述球形部确保神经、组织和/或硬脑膜在切割过程中受到保护。 The non-cutting end of said spherical portion to ensure protection nerves, tissue and / or dura are protected during the cutting process. 所述非切割保护端优选为钝面。 Preferably the non-cutting protective tip is a blunt surface. 所述非切割保护端最好有至少一个经过抛光的和/或光滑的表面部分,尤其是经过机械抛光的表面部分和/或经过电抛光的表面部分。 The non-cutting protective tip preferably has at least one polished and / or smooth surface section, in particular through the mechanically polished surface section and / or the surface portion of electropolished. 在优选的实施例中,所述非切割保护端和/或钻头元件具有光滑的最外层和/或涂层,尤其是质地平滑的涂层和/或j氐摩纟寮涂层,特别是聚四氟乙烯涂层。 In a preferred embodiment, the non-cutting protective tip and / or the drill member has a smooth outermost layer and / or coating, in particular a smooth texture coatings and / or Si j Di Liu friction coating, in particular Teflon coating. 选斧不锋利、表面光滑,可选择地涂上非粘结性材料,因为脊推管内的脆弱组织不会因与钻头的所述保护部粘结而受到伤害或拉伸,因而能够使组织得到更好的保护。 Ax selected from the blunt, smooth surface, optionally coated with non-adhesive material, because the delicate tissues within the spine will not push the pipe and the protective portion bonded bit hurt or stretched, it is possible to obtain tissue better protection. . 为了使所述非切割保护端的优势更加明显,优选的,所述保护部在远端方向(钻孔装置的轴向方向)的长度至少为5毫米,最好在5到15毫米之间,优选为5毫米、10毫米或15毫米。 In order that the advantages of the non-cutting protective tip is more obvious, the preferred length of the protective portion in the distal direction (axial direction of the drilling means) of at least 5 mm, preferably between 5-15 mm, preferably 5 mm, 10 mm or 15 mm. 这些不同的尺寸为穿过先前切割的骨骼中的管提供可靠的引导,但另一方面,当钻孔完毕时不在脊推管内延伸得太远,并且切割部只进入脊推管较短的距离。 These different dimensions as to provide reliable guidance through a previously cut in the bone tube, but on the other hand, when the completion of the drilling tube is not pushed ridges extending too far, only the ridges and the cutting portion into the push tube short distance . 所述非切割保护端的长度选择依赖于实际病人的解剖构造,特别是脊推管的大小和结构。 The non-cutting protective tip length actual choice depends on the patient's anatomy, in particular the size and structure of the ridge push tube. 优选地,所述非切割保护端是圆形的,并可能具有,例如半圆形的横截面、 半椭圆形的横截面或类似的圓的、光滑形的横截面。 Preferably, the non-cutting protective tip is circular, and may have, for example, semicircular cross section, a semi-elliptical cross-section or a similar rounded, smooth-shaped cross section. 在优选的实施例中,为了提供可靠的切割,所述切割部具有与所述非切割保护端邻近的切割端。 In a preferred embodiment, in order to provide reliable cutting, the cutting portion having the non-cutting protective tip adjacent the cut ends. 换句话说,钻头元件的纵轴与面向切割部的切割端垂直。 In other words, the longitudinal axis of the cutting element for a drill bit cutting end portion of the vertical. 在进一步优选的实施例中,所述钻头包括一个套筒,所述套筒的内直径选择为使钻头元件能够容易地插入并旋转。 In a further preferred embodiment, the drill bit comprising a sleeve, the inner diameter of the sleeve is selected so that the drill member can be easily inserted and rotated. 所述套筒用来在所述钻头插入体内时保护周围的组织以及所述钻头开动时保护组织。 The sleeve is used to protect the surrounding tissue and protecting tissue during the actuation of the drill bit inserted into the body. 在优选的实施例中,所述套筒在其近端有内螺紋,所述钻头元件在其近端前进。 In a preferred embodiment, the sleeve has an internal thread at its proximal end, said drill member advancing its proximal end. 通过这一设置,能够准确控制所述钻头元件相对于所述套筒的给进速度。 By this setting, it is possible to accurately control element relative to the drill bit feed rate of the sleeve. 当所述切割部没有自切割钻头螺紋而是一种铣刀时,这尤其有益。 When the cutting portion of the cutting bit from the screw but without a milling cutter, which is particularly advantageous. 在优选的实施例中,所述手术钻头的所述钻头元件在所述钻头元件内具有沿轴向延伸的同轴导引通道,因此导引线可以插入到导引通道中。 In a preferred embodiment, the member of the surgical drill bit with a coaxial guide channel extending axially within the drill bit element, so the guide wire may be inserted into the guide channel. 优选地,所述导引通道从所述钻头元件的远端延伸到所述钻头元件的近端。 Preferably, said guide channel extending from the distal end to the proximal end of the drill member of the drill bit element. 这种导引线, 如下面解释的那样,是用来引导所述钻头元件沿着所述导引线进入到病人体内所需要的位置,特别有助于提高精度以及减少手术持续的时间。 This guidewire, as explained below, is used to guide the drill bit along the guide wire into the element to a desired location within the patient, in particular, help to improve accuracy and reduce the duration of the operation. 所述钻头元件的所述切割部例如可以是钻孔锥、环钻、铣刀、铰刀或环锯。 The cutting portion of the drill bit element may be, for example, a burr, a trephine, milling cutters, reamers, or trephine. 所述切割部也可以具有钻头螺紋。 The cutting portion may have a bit threads. 在优选的实施例中,所述手术钻头在所述钻头元件的近端具有手柄、可拆卸的手柄和/或连接到机械钻的连接器,从而允许外科医生根据不同的情况选择适当的驱动方式。 In a preferred embodiment, the surgical drill having a handle member at the proximal end of the drill bit, a removable handle and / or mechanically connected to the drill connector, allowing the surgeon to select the proper drive mode depending on the circumstances . 本发明的目的还通过权利要求18所述的手术钻头组来实现。 Further object of the present invention requires the operation of the bit group 18 is achieved by the claims. 手术钻头组至少包括如上所述的一个第一手术钻头和一个第二手术钻头。 Operation including at least one drill bit as described above, a first operation and a second surgical drill. 此外,所述第一手术钻头的切割部的外直径等于或大于所述第二手术钻头的非切割保护端的外直径。 In addition, the first surgical drill outer diameter of the cutting portion is equal to or greater than the outer diameter of the protective non-cutting end of the second surgical drill. 正如上面解释过的,这样两个钻头的配置而成的钻头组能够用来成功地扩展骨骼中已经存在引导通道。 As explained above, so that the drill bit configured of two bit groups can be used successfully extended guide channel already exists in the bone. 所述手术钻头组中的所述第一手术钻头的非切割保护端进入骨骼中预先钻出的引导通道。 The first operation of the surgical drill bit group of the non-cutting protective tip in a pre-drilled into the bone guide passageway. 然后驱动所述第一手术钻头,产生具有与所述第一手术钻头的切割部的外直径相对应的内直径的通道。 Then drives the first surgical drill, generating channels having an outer diameter of the inner diameter of the cutting portion of the first surgical drill corresponding to FIG. 所述第一手术钻头产生的所述通道定心于所述引导通道。 The passage of the first surgical drill is centered on the generated guide channel. 在所述第一手术钻头完成钻孔并且钻出与所述第一手术钻头的切割部的外直径相对应直径的通道之后,插入所述第二手术钻头,将它的非切割保护端插入所述第一手术钻头钻出的通道。 The outer diameter of the cutting portion is completed in the first bore and the drilling operation with the drill bit after the first operation corresponding to the diameter of the passage, the second surgical drill is inserted, it is a non-cutting protective tip is inserted into the said first surgical drill drilled passage. 接下来,驱动所述第二手术钻头以扩大由所述第一手术钻头钻出的所述通道。 Next, the driving of the second surgical drill to expand the channel drilled by the first surgical drill. 由所述第二手术钻头钻出的所述通道具有与所述第二手术钻头的切割部的外直径相对应的内直径。 Drilled by the surgical drill the passage having a second inner diameter of the outer diameter of the cutting portion of the second operation corresponding to the bit. 所述第二手术钻头钻出的骨骼中的通道定心于由所述第一手术钻头钻出的通道。 The second surgical drill drilled bone channel centered on said first drilled by the surgical drill passage. 可以按照这一方法,改变所需的不同钻头的数量,直到最后一个手术钻头切割部的外直径与进行骨骼内即脊推管手术的骨骼中所需要通道内直径相对应。 According to this method can change the number of different desired bit diameter corresponding to the outer diameter of the inner passage through the bone last surgical drill cutting portion and push tube for spinal surgery, i.e. the bone as required. . 在优选的实施例中,所述手术钻头组包括多个手术钻头,其切割部的切割直径分别为3毫米、4毫米、5毫米、6亳米、7毫米、8毫米、9毫米、10毫米、 11毫米和12毫米。 In a preferred embodiment, the surgical drill bit group comprises a plurality of surgery, the cutting diameter of the cutting portion was 3 mm, 4 mm, 5 mm, 6 millimeters, 7 mm, 8 mm, 9 mm, 10 mm, 11 mm and 12 mm. 直径也可以优选为3.5亳米、4.5毫米、5.5毫米、6.5毫米、 7.5毫米、8.5毫米、9.5毫米、10.5毫米、11.5毫米和12.5毫米。 Diameter preferably may be 3.5 millimeters, 4.5 mm, 5.5 mm, 6.5 mm, 7.5 mm, 8.5 mm, 9.5 mm, 10.5 mm, 11.5 mm and 12.5 mm. 在进一步优选的实施例中,所述手术钻头組钻头的切割部直径为4毫米、6毫米、8毫米和10 毫米,所述手术钻头组的相应的所述非切割保护端的直径分别为2毫米、4毫米、 6毫米和8毫米。 In a further preferred embodiment, the diameter of the cutting portion of the surgical drill bit group of 4 mm, 6 mm, 8 mm and 10 mm, the diameter of the respective non-cutting protective tip of the surgical drill group were 2 mm , 4 mm, 6 mm and 8 mm. 所述手术钻头的所述非切割保护端的直径如此选择,〗吏得他们能够^皮插入所述手术钻头组相对小一些的钻头所钻出来孔内。 The diameter of the non-cutting protective tip of the surgical drill bit selected so that they can have〗 Officials ^ percutaneous insertion of the surgical drill bit set relatively smaller hole drilled out. 在优选的实施例中,所有手术钻头的所述非切割保护端的轴向长度都相等。 In the preferred embodiment, all of the non-cutting protective surgical drill axial length of the end are equal. 本发明的目的还通过权利要求29所述的切割骨骼的系统来实现。 The present invention also requires the system 29 of the cut bone is achieved by the claims. 除了手术钻头,这一系统还包括一个插入身体的工作插管。 In addition to surgical drill, this system also includes a catheter inserted into the body of work. 所述工作插管是为了在适当直径的通道由现之后插入手术器械。 The working cannula is for the insertion of surgical instruments after a channel now appropriate diameter. 在优选的实施例中,所述系统还包括针,特别是18规格针,用于定位穿过身体组织的第一通道,而且,还包括插入这一通道的导引线。 In a preferred embodiment, the system further includes a needle, especially the 18 gauge needle, for positioning a first passage through the body tissue, and further comprising a guide wire is inserted into the channel. 使用这种针可以便于提供一个穿过骨骼周围组织的通道,使用导引线可以准确调准引导通道或第一钻孔通道的方向。 This may facilitate the use of a needle passage through the surrounding bone tissue, can be used to accurately guide wire alignment direction of the guide channel or passage of the first bore. 在另一个优选的实施例中,所述系统包括一个扩张杆,用于扩张体内的通道。 In another preferred embodiment, the system comprises an expansion rod for expanding the body passage. 由于这个附加的扩张杆,体内的通道能够被扩张,最终使得所述第一手术钻头的所述套筒能够^L插入。 Because of this additional expansion rod body channel can be expanded, so that the final sleeve of the first surgical drill can be inserted ^ L. 此外,本发明的目的还通过权利要求34所述的移除骨骼的方法来实现。 Further, the object of the present invention is also a method of removing the bone 34 is achieved by the claims. 按照这种方法,骨骼的移除包括以下步骤:将具有起始直径的引导通道引入骨骼, 将切割直径大于起始直径的手术钻头伸入引导通道,手术钻头在其远端具有直径等于或小于引导通道起始直径的非切割保护端,在钻孔前,所述非切割保护端插入引导通道。 According to this method, the removal of bone includes the steps of: having a starting diameter of the guide passage introducing the bone, the surgical cutting diameter greater than the diameter of the initial drill extends into the guide channel, the surgical drill having a diameter equal to or smaller than at its distal end guide channel initial diameter of the non-cutting protective tip, prior to drilling, the non-cutting protective tip is inserted into the guide channel. 所述方法进一步包括将一系列的切割直径逐渐增加的手术钻头穿过前一个手术钻头产生的通道,其中所述非切割保护端的直径等于或小于前一个手术钻头的切割直径,所述非切割保护端^:插入由前一个手术钻头的切割部产生的通道中。 The method further comprising cutting a series of increasing diameter through the channel before a surgical drill bit generated by the operation, wherein the diameter of said non-cutting protective tip is equal or less than a diameter of the front cutting operation of the drill bit, the non-cutting protection end ^: insertion path by the front cutting portion of the drill bit in a surgically created. 在优选的这一方法的变换中,引导通道穿过各个骨骼的安全区,尤其是与骨骼管(如脊推管)相切。 In this preferred conversion process, the guide channel through the safe area of ​​each bone, especially bone tube (e.g. spinal push tube) tangent. 在这一方法的变换中,通过使钻头穿过关节嚢或肥大骨骼进入在神经条(硬脑膜)侧方的以及在分支和兴奋神经根中心的脊推管的安全区来产生引导通道。 In this conversion process, by passing through the joints of the drill into the bone in Nang nerve or mast section (dura) side of the spine and in the secure area of ​​the push tube excitatory nerve roots and branches of the central guide passage to produce. 在这一方法的第三个变换中,钻头进入病变的组织,例如推间盘突出部分、 小关节或骨骼嚢肥大、滑液嚢肿或肿瘤。 In a third transformation of this method, the drill bit into the diseased tissue, for example, the push portion herniation, facet hypertrophy Nang or bone, synovial fluid or tumor swelling Nang. 在进一步的变换中,手术钻头穿过引导通道,手术钻头具有一个非切割保护端,到最远端的距离为5亳米至15毫米,其中切割部的外直径比所述非切割保护端的直径大1毫米至2亳米。 In a further transformation, the surgical drill through the guide passage, the surgical drill having a non-cutting protective tip, the distance most remote from 5 millimeters to 15 millimeters, wherein the diameter of the outer diameter of the cutting portion than the non-cutting protective end Great 1 millimeter to 2 millimeters. 在这一方法的变换中,导引线伸入到引导通道,随后使用的器械由导引线引导。 In this transformation process, the guide wire projects into the guide channel, is guided by the subsequent use of the instrument guide wire. 采用这种导引线,优点在于将导引线插入在手术钻头的轴向延伸的引导通道。 With this guidewire, the advantage that the guide wire is inserted into the guide channel extending in the axial direction of the drill bit operation. 在这一方法的变换中,在骨骼中的引导通道产生之前,采用打开通道的针, 最好是18规格针,穿过骨骼周围的组织。 In this conversion process, prior to generating the skeleton of the guide channel, using the needle channel opening, preferably a 18 gauge needle through the tissue surrounding the bone. 在一个变换中,导引线伸入到由所述针所打开的通道中。 In one conversion, the guide wire projects into the needle by the open channel. 此外,扩张杆可伸入到由所述4十所打开的通道中来扩张所述通道。 In addition, extending into the expansion rod can be expanded by the ten 4 opens the passage channel. 更进一步,用套伸入经过扩张的通道,为第一手术钻头的工作纟是供工作通道。 Still further, the jacket extends into the passage through the expansion, the first surgical drill work for Si is a working channel. 附图说明图l是槽和手术钻头的俯视图;图2是18规格针、扩张杆、Yamshidi针的套筒和钻头的俯视图;图3是推间手术部位的横截面示意图;•图4是套和手术钻头插入骨骼结构时图3的手术部位的横截面示意图;图5是钻头釆用导引线引导时图3和图4的手术部位的横截面示意图;图6a和6b是通过非切割保护端钻到骨骼上的示意图;图7是工作插管通过组织时图3至图5的手术部位的横截面示意图;图8a和8b是钻头元件的两种不同的非切割保护端的视图;图9是套筒和手术钻头的近端的示意图,其具有互相匹配的螺紋部分;图10a和10b是进一步实施例的手术钻头的示意性侧视图;图lla和llb是与图10a和10b相关的进一步实施例的手术钻头的示意性侧视图;图12是图10a、 10b、 lla和lib中手术钻头的手柄的示意性俯^L图。 BRIEF DESCRIPTION OF DRAWINGS Figure l is a top plan view of a groove and a surgical drill bit; FIG. 2 is a 18 gauge needle, the expansion of the rod, a top view of the sleeve and the drill bit Yamshidi needle; FIG. 3 is a transverse schematic view of the surgical site sectional intervertebral; • Figure 4 is a sleeve cross-section of the surgical site schematic view of FIG. 3 and surgical drill is inserted into a bone structure; FIG. 5 is a cross-sectional schematic view of the drill wire guide preclude the use of a surgical site of Figure 3 and Figure 4; Figures 6a and 6b are protected by a non-cutting a schematic view of the bone drill end; FIG. 7 is a schematic view of the working cannula through tissue cross-section of a surgical site FIGS. 3 to 5; Figures 8a and 8b are two different views of the drill bit elements of the non-cutting protective tip; FIG. 9 It is a schematic view of the proximal end of the sleeve and the surgical drill, which has a threaded portion matching each other; FIGS. 10a and 10b are a schematic side view of a further embodiment of the surgical drill of the embodiment; FIGS lla and llb are associated with further Figures 10a and 10b a schematic side view of an embodiment of the surgical drill bit; FIG. 12 is a graph 10a, 10b, lla and lib schematically the handle of the surgical drill a plan ^ L in FIG. 具体实施方式图1示出了本发明的手术钻头1,其中包括具有切割部11和非切割保护端12的钻头元件10。 DETAILED DESCRIPTION Figure 1 shows a surgical drill 1 according to the present invention, wherein the member comprises a drill bit having a cutting portion 11 and non-cutting protective tip 10, 12. 所述切割部11的外直径d,与在骨骼中实际切割的直径相对应。 The cutting portion 11 of an outer diameter d, the diameter of the bone corresponding to the actual cutting. 此外,切割部11具有用于切割骨骼的钻头表面结构110。 In addition, the cutting portion 11 having a drill bit for cutting the bone surface structure 110. 切割部11位于钻头元件10的远端。 The cutting portion 11 located at the distal end 10 of the drill element. 非切割保护端12的直径为d。 End of the non-cutting protection diameter 12 is d. 非切割保护端12的直径d小于切割部ll的直径d,。 Diameter d of the protective non-cutting end of the cutting portion 12 is smaller than the diameter d ll ,. 具体来说,图中实施例的切割部11的直径和非切割保护端12的直径的差d,-(^lmm。所有的图都不是按照尺寸画出的。所述非切割保护端12为光滑钝面,所述钝面有表面涂层,不与脊推内的组织粘结。所述非切割保护端12的表面涂层由低摩擦的涂层构成,例如聚四氟乙烯涂层,和/或质地平滑的涂层,和/或有类似特性的表面涂层。 所述钻头元件IO在其近端具有手柄15。所述钻头元件IO具有套筒2,当所述钻头元件IO插入身体时套筒2覆盖所述钻头元件10。所述套筒2具有套筒通道20,所述套筒通道20的内直径为d"。 所述套筒通道20的内直径d"选取为所述手术钻头1的所述钻头元件10能够被插入,并通过套筒的套筒通道20前进。在本发明的优选实施例中,套筒2的尺寸能够使所述钻头元件IO在套筒2 内旋转而不使套筒2移动,但是另一方面,优选套筒2的外直径在满足上述条件 Specifically, FIG diameter and non-cutting protection diameter end of the cutting portion 11 of the embodiment 12 of the difference d, - (^ lmm all figures are not drawn according to the size of the non-cutting protective tip 12. blunt smooth surface, the blunt surface with a surface coating, bonding to tissue not push the ridge. the non-cutting end surface of the protective coating 12 is composed of a low friction coating, such as polytetrafluoroethylene coating, and / or a smooth coating texture, and / or a surface coating similar properties. the drill bit element 15. the element of the IO IO having a handle at its proximal end a sleeve 2, when the bit element is inserted IO the sleeve covering the body 2 of the drill bit 10. the sleeve member 2 has a sleeve channel 20, the inner diameter of the sleeve 20 is D-channel. "the inner diameter of the sleeve channel 20 is D" are chosen to said surgical drill the drill bit 10 can be inserted into the element 1, and the sleeve 20 is advanced through the sleeve channel. in a preferred embodiment of the present invention, the sleeve 2 can be the size of the drill in the sleeve member 2 IO 2 is moved without causing rotation of the inner sleeve, but on the other hand, the outer diameter of the sleeve 2 preferably satisfies the above conditions 情况下尽可能得小。换句话说,套筒2的壁厚最好较薄。这个套筒最好是采用这样一种材料制造,允许套筒的壁厚较薄,例如不锈钢或其他具有类似属性的材料。在本发明的另一个优选实施例中,套筒2的外直径对应随后插入的钻头元件10的内直径,使得套筒2的外直径扩张套筒周围的组织,以便能够将后面的套筒和/或钻头插入体内。所述套筒2的表面涂层使得筒套2容易插入身体组织。这一表面涂层包括质地平滑的涂层和/或低摩擦涂层,例如聚四氟乙烯涂层。在图2中,进一步包含了图1中的手术钻头1和套筒2所构成的系统中的其他元件。图2示出的规格18的空心针3是用来在骨骼结构中打开第一个通道,图1中的手术钻头1将在这个通道继续工作。空心针3在其洞内有一个套管针(trocar) (未图示),这个套管针可以在针3通过組织插入体内时标记引导开口(pilot no As small as possible in the case. In other words, the wall thickness of the sleeve 2 is preferably thin. Preferably the sleeve is to use a material that allows the wall thickness of the sleeve is thin, having, for example, stainless steel or other similar material properties. in another preferred embodiment of the present invention, the outer diameter of the sleeve element 2 corresponds to the bit 10 is then inserted in the inner diameter, the outer diameter of the expandable sleeve so that the tissue around the sleeve 2, so as to enable later the sleeve and / or drill into the body. the surface coating of the sleeve 2 so that the cylindrical sleeve 2 is easily inserted into the body tissue. the surface coating comprises a smooth texture coating and / or low friction coating, e.g. polytetramethylene vinyl fluoride coating. in FIG. 2, further comprising a surgical drill systems other elements in Fig. 1 and the sleeve 2 formed in. FIG. 2 shows the specifications of the hollow needle 18 is used in the skeletal structures 3 open the first channel, the operation of the drill bit of FIG 11 will continue to work in this channel. 3 has a hollow needle trocar (trocar) (not shown) in its hole, the trocar needle 3 can be when inserted into the body through the guide mark tissue opening (pilot no tch),使得钻空时能够位于适当的位置。在引导开口进入骨骼之后,套管针从针3中撤回,针3还保持不动,细的导引线4被插入针3的洞内,使得导引线4 的一头在引导开口的位置接触骨骼。图2示出的扩张杆5包括一个从近端到远端穿过扩张杆、轴向延伸的引导通道51。导引线4被插入到扩张杆5的引导通道51中,使得扩张杆5沿着导引线4被引导到骨格和骨駱内的引导开口。所述扩张杆5在其远端具有扩展端50, 最大直径为d",,最好等于或略小于在后面介绍的Yamshidi套筒7的内直径。 扩张杆扩张骨骼周围的组织。Yamshidi套筒7是Yamshidi针的一部分。 TCH), making it possible to drill in the proper position empty. After the opening of the guide into the bone, the trocar is withdrawn from the needle 3, the needle 3 is also held stationary, a thin guide wire 4 is inserted in the pin hole 3, 4 so that a guide wire at the position of the guide contacts the bone opening. FIG. 2 shows the expansion of the rod 5 through the expansion rod comprises a proximal end to the distal end of the axially extending guide channel 51. the guide wire 4 is inserted expansion of the guide channel 51 to 5, so that the expansion rod 54 is guided along the guide wire into the guide opening in the bone skeleton and Luo. the expansion rod 5 has an extension 50 at its distal end, the maximum diameter d ",, preferably equal to or slightly smaller than the inner diameter of the back presentation Yamshidi sleeve 7. .Yamshidi expandable sleeve surrounding bone tissue is a part of the expansion bar 7 Yamshidi needle. 将所述Yamshidi套筒7放在扩张杆5的位置,以引导Yamshidi套筒7到正确位置。 Yamshidi sleeve 7 in the expanded position of the lever 5 to guide the Yamshidi sleeve 7 into the correct position. 随后,扩张杆从Yamshidi套筒7处撤回,Yamshidi针的Yamshidi套管针(未图示)被插入到Yamshidi套筒7内,在引导开口的位置、以外科医生所决定的角度产生骨骼结构中的引导孑L 最好在二维X光下进行上述操作。 Subsequently, the expansion rod is withdrawn from the Yamshidi sleeve 7, Yamshidi needle Yamshidi trocar (not shown) is inserted into the Yamshidi sleeve 7, in the position of the guide opening to an angle determined by the surgeon to generate the bone structure L larvae guide above operation is preferably carried out at a two-dimensional X-ray. 随后,Yamshidi套管针从Yamshidi套筒7中撤回,传统的钻头8被插入到Yamshidi套筒7中,在引导孔的位置和角度钻出骨骼内的引导通道。 Subsequently, Yamshidi trocar is withdrawn from the Yamshidi sleeve 7 and conventional drill 8 is inserted into the Yamshidi sleeve 7, guide channels drilled in the bone at the position and angle of the guide hole. 在引导通道钻好之后,传统的钻头从Yamshidi套筒7上取下,重新将扩张杆5放入Yamshidi套筒7,继而离开身体。 After the guide channel drilled, the conventional drill is removed from the Yamshidi sleeve 7 into the re-expansion rod 5 Yamshidi sleeve 7, and then away from the body. 图1所示的手术钻头1的套筒2被放在扩张杆5的位置,扩张杆5随后从套筒2处撤回。 Surgical drill sleeve 1 shown in FIG. 12 is placed in the position of the expansion rod 5, the rod 5 is then withdrawn from the expansion of the sleeve 2. 接着, 手术钻头1的钻头元件IO进入套筒2,其非切割保护端被插入钻入骨骼的引导通道,继而钻头元件工作,将引导通道扩张至手术钻头1的切割部11的外直径。 Subsequently, the IO surgical drill bit 1 into the sleeve element 2, which is non-cutting protective tip is inserted into the guide channel drilled into the bone, and then drill element work, the surgical drill guide channel is expanded to an outer diameter of the cutting portion 11 1. 至此,图2示出了几件用于准备手术部位的器械,以使图l所示的手术钻头能够进入。 Thus, FIG 2 shows several instruments used to prepare the surgical site so that the surgical drill shown in Figure l can enter. 图3示出了脊推结构6的横截面。 FIG 3 shows a cross-section of the ridge pushed structure 6. 具体来说,图3示出了推间侧面的肌肉组织60、推间盘环面61、脊推管62、内核63、 一部分突出/滑出的推间盘64、 小关节65、硬脑膜66、小关节嚢67和神经根68。 Specifically, FIG. 3 shows the muscle tissue 60 pushes the side of the annulus between the push plate 61, push tube 62 the ridges, the core 63, a portion projecting in / out between the push plate 64, the small joints 65, the dura 66 facet joint nerve root Nang 67 and 68. 从中可以看出,突出的推间盘64压迫硬脑膜66和一部分神经根68。 As can be seen, the push plate 64 between the projection 66 and the compression of the dural nerve root portion 68. 这给病人造成疼痛。 This causes pain to the patient. 因此,任务就是要移除这一突出,清除不属于脊推管62的任何组织。 Therefore, the task is to remove the highlight, Clear does not belong to any organization ridge push tube 62. 为了移除这一突出,需要在骨骼结构中打开通道,特别是通过小关节65和小关节嚢67进入脊推管62。 To remove this projection, it is necessary to open the channel in the bone structure, in particular by small joints 65 and 67 into the small joints of the spine Nang push tube 62. 打开这一通道的过程阶段如图4所示。 This open channel process stage shown in FIG. 图4示出了图3中的脊柱结构,被第一套筒2包围着的第一手术钻头1被插入推间侧面的肌肉组织60,沿着预先钻好的引导通道650钻通小关节65的第一部分。 FIG 4 shows a spinal column in FIG. 3, is surrounded by a first sleeve 2 a first surgical drill 1 is inserted into the muscle tissue 60 between the push side along the guide channel 650 pre-drilled through the small joints of the drill 65 the first part. 第;个钻孔步骤是通过将第一手术钻头l从第一套筒中取回,第二手术钻头的具有比第一套筒大的直径的第二套筒放在第一套筒的位置,从第二套筒中取回第一套筒。 First; th drilling step is performed by the first surgical drill l retrieved from the first sleeve, the second sleeve has a larger diameter than the first sleeve in a second position of the first surgical drill sleeve retrieved first sleeve from the second sleeve. 接下来,将第二手术钻头插入第二套筒,其非切割保护端插入由第一手术钻头钻出的通道。 Next, the second surgical drill is inserted into a second sleeve, which is non-cutting protective tip is inserted into drilled passage by the first surgical drill. 第三到第n个钻孔步骤也是如此。 Third to n-th drilling step as well. 从图5可以看出,在经过n个钻孔步骤之后,最后一个手术钻头l,沿着导引线4'被插入到手术部位。 As it can be seen from FIG. 5, after the n drilling steps, the last surgical drill l, 4 'are inserted into a surgical site along the guide wire. 导引线4,在前一个手术钻头从其套筒中取出后被插入到通道651中。 Guide wire 4, inserted into the passage 651 after being taken in from the previous one surgical drill sleeve. 接着前一个套筒也被取出,只剩下比较粗的(约1-2毫米)的导引线4,留在身体内部。 Then before a sleeve is also removed, leaving only a relatively thick (about 1-2 mm) of the guide wire 4 remains inside the body. 最后一个手术钻头l,具有一个通孔13,所述通孔沿着绅线方向从钻头元件10的近端到远端延伸并被放置在导引线4'的位置。 L last surgical drill, having a through hole 13, the through hole extending guide wire and placed in position 4 'of the drill member 10 from the proximal end to the distal end along the direction of line gentry. 在优选的实施例中,最后一个手术钻头l,不包含套筒,以^使最后一个钻孔步骤的外直径尽可能的小,以使对周围组织的压力尽可能的低。 In a preferred embodiment the outer diameter of the embodiment, the last surgical drill L, does not include the sleeve, in order that the ^ final drilling step as small as possible, so that the pressure of the surrounding tissue as low as possible. 在如图5所示的阶段,手术钻头1已经几乎穿过了小关节65,钻孔部接下来试图穿过小关节嚢67。 In the stage shown in FIG. 5, the surgical drill 1 has almost passed through the facet joint 65, the next attempt through a small bore portion 67 Nang joint. 在这种情况下,非切割保护端12已经进入脊推管62并接触到了突出的推间盘64。 In this case, the non-cutting protective tip 12 has been pushed into the spine and contact the tube 62 between the projection 64 of the push plate. 但是,由于非切割保护端12不锋利并且具有光滑的表面,突出的推间盘64只被推离这一区域。 However, since the non-cutting protective tip 12 does not have a smooth surface and sharp, protruding between the push plate 64 is pushed away from the region. 即使它只是病变组织,也不会直接移除这一组织。 Even if it's just the diseased tissue, it does not directly remove the tissue. 由于病变组织能够在后续步骤中可控地被移除,这样做增加了可靠性。 Since the diseased tissue can be controllably removed in a subsequent step, this increases the reliability. 此外,在硬脑膜66或神经根68处于钻孔方向的情况下,非切割保护端12在切割过程中轻轻地推走这一组织。 Further, in a case where the dura 66 or the nerve roots 68 are in the drilling direction, the non-cutting protective tip 12 during cutting of the tissue gently away. 换句话说,由于非切割保护端12 首先进入脊推管,它可以使脊推管66内的所有脆弱组织和神经离开切割部11 的尖锐切割边。 In other words, since the non-cutting protective tip first into the spine 12 of the push tube, push tube which can make all spinal nerves and delicate tissues away from the cutting portion 66 of the sharpened cutting edge 11. 此外,从图6可以看出,非切割保护端12帮助引导钻头元件IO穿过小关节65内已有的引导通道650。 Further, it can be seen from FIG. 6, the non-cutting protection and guide a drill bit through the IO facet joint member 65 has an end 12 of the guide channel 650 help. 从图6a中显而易见,非切割保护12被插入到小关节65内的引导通道650,由此钻头元件IO和切割部11定位在引导通道650 的中央。 Apparent from Figure 6a, the non-cutting protection 12 in the guide channel 650 is inserted into the facet joint 65, whereby the drill bit and the cutting element IO portion 11 positioned in the center of the guide passage 650. 从图6b中可以看出,当钻头元件IO钻过小关节65,形成与切割部ll 的外直径d,相应的扩张通道651 。 As can be seen in Figure 6b, when the bit IO drilled facet joint element 65, the cutting portion formed ll outer diameter d, the respective expansion channels 651. 扩张通道651与先前切割的《1导通道650同轴。 Previously cut with the diverging channel 651 "1 650 coaxial guide channels. 采用这种方式,通道651可以被扩张,直至达到所需直径。 In this manner, the channel 651 may be expanded until it reaches the desired diameter. 非切割保护端12用于保护脊推管62内的脆弱组织。 Non-cutting protective tip 12 for protecting delicate tissues within the push tube 62 ridges. 图7示出了与图3至图5相同的手术部位。 Figure 7 shows the same as FIG. 3 to FIG. 5 of the surgical site. 在图中使用工作插管9穿过组织插入骨骼,因而外科医生可以将手术器械插入工作插管9来对脊推管内的组织进行操作。 Use working cannula 9 is inserted through the bone tissue in the drawings, the surgeon may thus be inserted into the working cannula 9 surgical instruments to operate the push tube tissue in the spine. 图8示出了钻头元件10两种不同的非切割保护端。 Figure 8 shows different two kinds of the bit member 10 non-cutting protective tip. 方式a中的切割部11 具有类似钻头螺紋的表面结构111。 Cutting a portion of the embodiment 11 has a surface structure similar to the drill bit 111 is threaded. 方式b中的切割部ll有所不同,其具有类似铰刀的表面结构112。 Cutting portion ll b in different ways, having a surface structure similar to the reamer 112. 非切割保护端的长度l在5毫米和15毫米之间。 Non-cutting protective tip length l is between 5 and 15 mm. 图9示出了手术钻头1和套筒2的组合体的近端。 Figure 9 shows a surgical drill 1 and the proximal end of the sleeve 2 combination. 手术钻头1的钻头元件10有外螺紋122,与套筒的内螺紋222相对应。 Surgical drill bit 10 of element 1 has an external thread 122, with the inner threaded sleeve 222, respectively. 这种配置使得外科医生能够以可控的方式将手术钻头1狞进套筒2中。 This configuration enables the surgeon to surgery in a controlled manner into the drill sleeve 1 2 hunting. 当切割部是^t刀,没有内螺紋以通过旋转拧进手术钻头时尤其有益。 When the cutting knife portion is a ^ t, without an internal thread is screwed into the rotational operation through the drill bit particularly advantageous. 使用上文所述的手术器械,可以形成将脊推管内的各种各样的病变组织暴露出来的方法,其中包括步骤:1. 将第一钻头或针穿过关节嚢或肥大骨骼进入脊推管的安全区,所述脊推管位于神经条(硬脑膜)的侧方以及在分支和兴奋神经根的中心,可能进入病变组织,例如推间盘突出部分、小关节或骨骼嚢肥大、滑液嚢肿或肿瘤。 Using the surgical instrument described above, the method of diseased tissue in a variety of push tube exposed ridges may be formed, which comprises the steps of: a first drill or needle through the joint into the bone ridge or mast Nang push security zone tube, push tube side of the ridge strip positioned nerve (dura mater), and in the central branch and excitatory nerve root lesions may enter, for example, the push portion herniation, facet joint or bone Nang hypertrophy, slip Nang swelling or liquid tumors. 2. 成功地插入手术钻头1,所述手术钻头1具有5-15亳米的不锋利的非切割保护端12以及距离非切割保护端10至15毫米的旋转切割端11,在切割处直径大1-2毫米。 2. successfully inserted into a surgical drill 1, the surgical drill 1 not having a sharp, non-cutting protection 5-15 millimeters from the end 12 and the rotation of 10 to 15 mm, non-cutting end of the cutting end 11 of the protection, at the large diameter cutting 1-2 mm. 沿着第一次旋转钻出的通道,手术钻头1的切割部11的直径逐渐增大。 Along the first rotation drilled passage, the diameter of the cutting portion 11 of the surgical drill 1 gradually increases. -3. P遺后的钻头透过6-11毫米的皮肤开口迟緩地穿透后面的腰部肌肉,通过保护套筒式插管,停留在腰推小关节和骨膜的骨骼边缘。 -3 drill bit through the left P 6-11 mm openings slowly penetrate the skin behind the back muscle, the protective sleeve through the cannula, the edges remain in the lumbar facet joint bone and periosteum. 基于背部开口所需要的尺寸,可能在6-12毫米之间变化,放置相应尺寸的工作插管。 Back opening of desired size, may vary between 6-12 mm, is placed on a corresponding size working cannula. 通过这种插管,可以插入各种脊柱内窥镜和器械。 Through this cannula, endoscopic spinal and you can insert various instruments. 要意识到,本发明的方法不在移除组织的钻头一端采用铰刀式的切割端,并且钻头具有至少5毫米长的钝面保护部, 避免切割或伤害脊推神经或^J亩膜。 It is appreciated that the inventive method is not employed to remove tissue cutting end of the drill bit end of reamer-type, and a drill bit having at least 5 mm long blunt surface protection part, to avoid cutting or damage to nerves or spinal push ^ J mu film. 这种装置使得肥大关节嚢及其邻近的肥大黄韧带的移除变得安全,小关节骨骼肥大移除也变得安全,特别是在脊推管狭窄时。 This means that the removal of the mast and the mast joint Nang flavum adjacent become safe, facet joint bone removal becomes mast safety, especially when the push spinal stenosis. 基于病变的范围,可以产生直至12毫米的开口。 Based on the extent of the lesion, it can be produced up to 12 mm opening. 可以从一侧进行,如果需要,也可以从两侧进行。 May be performed from one side, if desired, may be performed from both sides. 在存在双边狭窄或需要插入一个脊推内的笼状物时采用后者。 The latter in the presence of bilateral stenosis or push needs to be inserted in a ridge cage. 由于在过程中不会明显地触碰脊推神经,因而可以在局部麻醉下进行。 Because obviously not touch the spinal nerve push in the process, which can be done under local anesthesia. 在优选的实施例中,通过规格18脊柱针来完成脊推管后外侧的开口。 In a preferred embodiment, to complete the opening of the outer ridges of the push tube 18 by a standard spinal needle. 在麻醉后外侧的皮肤之后,在角度为60度,距离脊柱的中心线10-14厘米处,在X光增强器的成像下进行上述操作,直接对准脊推管内的病变部位。 After the outer skin of anesthesia, the angle is 60 degrees, 10 to 14 cm from the center line of the spine, the above operations in the X-ray image intensifier, directly at the spinal lesion within the push tube. 一旦脊柱针碰到骨骼结构,移走脊柱针的套针,插入导引线。 Once the spinal needle hits bony structure, the spine is removed trocar needle, guide wire inserted. 通过这个导引线,将具有圆锥形尖部的扩张杆插入到骨骼结构,以扩张软组织。 Through this guide wire, the tip having a conical expansion portion of the rod is inserted into the bone structure, to dilate the soft tissue. 随后插入并移走3毫米的扩张管。 Followed by insertion and removal of 3 mm dilation tube. 随后插入具有2毫米内径及把手的3毫米的扩张管,作为第一引导器械。 It is then inserted and the handle having an inner diameter of 2 mm 3 mm dilation tube, as the first guide instrument. .接下来,移除导引线,放入标准长度的手持钻。 Next, the guide wire is removed, placed in hand-held drill standard length. 第一引导器械是用来在二维增强器成像的帮助下将钻对准病变结构的方向。 The first guiding instrument is used with the aid of a two-dimensional imaging intensifier drill alignment direction lesion structure. 然后钻进入安全区,直到碰到病理结构并产生l-2厘米长、直径为2毫米的引导通道。 Then drill into the safe zone until the pathological structure and generating a hit l-2 cm long, 2 mm diameter of the guide channel. 随后移走钻并用导引线替代它。 Then remove and replace it with the drill guide wire. 采用导引线产生具有工作插管所需要的直径的扩张通道。 Generated using diverging channel having a guide wire diameter work required of the cannula. 在软组织扩张至骨骼后,插入本发明的具有0.5-1.0厘米长的钝面保护部的第一手术钻头。 After the soft tissue to the bone expansion, the insertion operation of the present invention has a first portion of the bit length of 0.5-1.0 cm blunt protective surface. 手术钻头的保护部的直径为2毫米,切割部的直径为3毫米。 Surgical drill diameter of the protective portion 2 mm, diameter of the cutting portion is 3 mm. 采用手术钻头, 脊推管内的开口扩大到3毫米。 Surgical drill the opening in the tube to expand to push the ridge 3 mm. 继而移走这种特殊的钻头,并插入导引线。 This special drill is then removed and inserted into the guide wire. 随后,放入一个具有钝面保护部和切割部的钻,保护部的直径为3毫米,切割部的直径为4毫米。 Subsequently, blunt drill into a protected portion and a cutting portion face having a diameter of 3 mm protected portion, the diameter of the cutting portion is 4 mm. 继而增大钻头的直径并重复这些步骤。 Then increasing the diameter of the drill bit and repeat these steps. 这一钻头组包括多个直径以1亳米增加的多个钻头。 This group includes a plurality of drill bit diameter in a plurality of millimeters increased. 在这样的方式下,脊推管的开口能够达到12毫米。 In this manner, the opening ridge push tube can reach 12 millimeters. 当开口达到需要的通道直径时,插入相应的工作插管,从而可以将脊推内窺镜和器械伸入插管中。 When the opening diameter of the channel reaches desired, into the corresponding working cannula, thereby pushing the endoscope and the instrument ridges may extend into the cannula. 为了控制手术程序并能准确地对准手术器械,可以在X光增强器成像或其他适合的成像设备下进行如下几个步骤,插入第一针以打开通过组织的第一通道,伸入Yamshidi针并调节角度并产生引导开口( introducing a pilot hole),在引导通道钻孔并控制钻孔的深度。 In order to control the surgical procedure and can be accurately aligned with the surgical instrument, the following steps may be performed in the X-ray image intensifier or other suitable imaging device, inserted into the first passage through the first needle opens tissue, the needle extends into the Yamshidi and adjusting the angle and generating a guide opening (introducing a pilot hole), the depth of the guide channel and control the drilling of the borehole. 在这些步骤之后,钻孔的行为以及后续的手术工作就可以在X光增强器成像或其他适合的成像设备下可控地进行。 After these steps, the behavior of the drilling and subsequent surgical work can be carried out controllably in the X-ray image intensifier or other suitable imaging device. 图10和11示出了本发明另一个实施例中的钻头组。 10 and 11 illustrate the present invention in another embodiment the bit group. 具体来说,图10a和10b示出钻头组中的第一钻头,而图lla和llb示出钻头组中的第二手术钻头。 Specifically, FIGS. 10a and 10b show a first drill bit group, while FIGS lla and llb show a second surgical drill bit group. 图10a和10b中的手术钻头l"的切割部ll'的第一外直径d,l为4毫米。在这个实施例中非切割保护端12,的直径dl为2毫米。切割部11'的轴向长度是25 毫米。按照图10a和10b所示的实施例,非切割保护端12,包括一个位于切割部11, 远端的圆柱部120。在圆柱部120的远端有一圆锥部122,在圆锥部的远端有一球形部124。在这个实施例中,圆锥部122大体为圓锥形。球形部124大致为半球形状,但也可以是椭圆的、抛物线形的或其他任何能够进一步减少非切割保护端对各种软组织或神经影响的形状。如上所述,球形部124进一步改善了非切割保护端12,的保护性能,它的光滑圆边不会割断或损害神经、组织和/或硬脑膜。圆锥部122用来方便和安全地将手术钻头l"插入到骨骼中的已经钻好的孔和/或已经钻好的管道中。 Figures 10a and 10b surgical drill l "cut portion ll 'a first outer diameter d, l 4 mm. Example Africa dicing end 12 in this embodiment, 2 mm diameter dl. Cutting portion 11' the axial length of 25 mm according to the embodiment shown in FIG. 10a and 10b, the protective non-cutting end 12, the cutting portion 11 comprising a distal end at the distal end of the cylindrical portion 120. the cylindrical portion 120 has a tapered portion 122, the distal end taper portion has a spherical portion 124. in this embodiment, the conical portion 122 is substantially conical. spherical portion 124 is substantially hemispherical shape, but may be elliptical, parabolic or any other can be further reduced non-cutting protective tip shape of soft tissue or nerves influences. As described above, the spherical portion 124 further improves the protection of the non-cutting end 12, protective properties, its smooth circular edge not cut or damage nerves, tissue and / or dura. conical portion 122 for conveniently and safely surgical drill l "is inserted into the bone hole has been drilled and / or already drilled pipe. 圓柱部120用来安全地对手术钻头l"特别是钻头元件IO对于已经钻好的孔定心。钻头元件10的在非切割保护端12,的远端及手柄15之间的长度L约为200 毫米。手柄15在^t向延伸约75毫米。图lla和llb所示的手术钻头l,"与图10a和10b所示的手术钻头l"的结构基本相同。具体来说,钻头元件IO也包括切割部ll,和非切割保护端12',其中非切割保护端12V人近端到远端包括,圆柱部120、圆锥部122和球形部124。 钻头元件10的长度L约为200毫米,手柄15在横向延伸的距离H约为75毫米。 在图10a和10b所示的手术钻头l,,中,手柄15是可拆卸的手柄,可以从钻头元件IO上拆下。在图10a和10b所示的手术钻头l"中,切割部ll,在轴向方向的长度为25毫米。 Cylindrical portion 120 for securely surgical drill l "for the particular IO bit element 15 has a length between the centering holes drilled drill bit in the non-cutting protection element 10 end 12, a distal end and a handle L is about 200 mm a handle 15 extends from about 75 millimeters ^ t. Figure lla and llb surgical drill l, "l and surgical drill bit shown in FIG. 10a and 10b" substantially the same structure. in particular, the drill member including IO cutting portion ll, and non-cutting protective tip 12 ', wherein the non-cutting protective tip includes a proximal to distal 12V person, a cylindrical portion 120, the length of the drill bit element 124. the conical portion 10 and the spherical portion 122 L of about 200 mm, the handle 15 laterally extending at a distance H of about 75 mm. in FIGS. 10a and l ,, surgical drill shown in 10b, the handle 15 is detachable handle, the bit can be removed from the IO device. FIGS. 10a and 10b in the surgical drill illustrated l ", the cutting portion ll, in the axial longitudinal direction is 25 mm. 然而,在图lla和llb所示的实施例中,手术钻头l,"的直径与在图10a和10b所示的手术钻头l"的直径不同。 However, in the embodiment illustrated in FIGS lla and llb, the surgical drill l, the different "in diameter and l bit operation shown in FIG. 10a and 10b" in diameter. 具体来说,在手术钻头r"的实施例中,切割部ll,的外直径d'2为6毫米,而非切割保护端12,的外直径d2为4亳米。因此,图lla和llb所示的手术钻头l,"的非切割保护端12,能够被插入由图10a和10b所示的手术钻头l"预先钻出的孔或通道中。接下来,图lla和llb所示的手术钻头r"对于已经由手术钻头r,钻好的孔和/或通道准确地定心。 Specifically, the surgical drill r "embodiment, the cutting portion ll, d'2 of the outer diameter of 6 mm, instead of the dicing end 12, an outer diameter d2 is 4 millimeters. Thus, FIGS lla and llb l surgical drill shown in "non-cutting protective tip 12 can be inserted by a surgical drill Figures 10a and l shown in FIG. 10b" pre-drilled holes or channels. Next, the operation of FIG. lla and llb bit r "has to be accurately centered by a surgical drill r, drilled holes and / or channels. 图12示出了图10a、 10b、 lla和llb中手术钻头l"和l,"的手柄15的俯视图。 FIG 12 shows a top view of FIG. 10a, 10b, lla and llb the surgical drill l "and l," the handle of FIG. 15. 具体来说,锁定机构150使得外科医生能够将可拆卸的手柄15锁定在钻头元件10上。 In particular, the locking mechanism 150 enables the surgeon to lock the removable handle 15 on the drill bit member 10. 此外,在钻头元件10的中心,有用于插入导引线的引导通道14。 Further, in the center drill member 10, the guide passage for inserting the guide wire 14. 图10a 和10b所示的手术钻头l"以及图lla和llb所示的手术钻头l,"都包括从远端向近端延伸的指导通道,所述引导通道14用于将导引线插入并从远端向近端穿过钻头元件10。 Figures 10a and l surgical drill shown in 10b "and shown in FIGS lla and llb surgical drill l," comprises a guide channel extending from the distal end toward the proximal end, the guide passage 14 for the guidewire and inserted into the through the cutting element proximally from a distal end 10. 本实施例中所有的手术钻头的引导通道14的内直径基本相同。 Substantially the same as the inner diameter of the guide passage 14 in the embodiment of all surgical drills of the present embodiment. 因此,图10a、 10b、 lla和llb所示的实施例给出了一种手术钻头组,所述手术钻头组包括至少两个手术钻头l"和l,",它们的切割部ll'的外直径d,l和d,2不同,非切割保护端12,的外直径dl和d2也不同。 Thus, FIG. 10a, 10b, lla and llb shown in embodiments gives a surgical drill bit group, the surgical drill bit comprises at least two surgical l "and l,", outside their cutting portion ll 'is diameter d, l and d, 2 different non-cutting protective tip 12, the outer diameter dl and d2 are different.

Claims (44)

1、一种手术钻头(1,1'),包括钻头元件(10),所述钻头元件(10)具有用于切割骨骼的切割部(11,11',11”),所述切割部位于所述钻头元件的远端,其中,所述钻头元件具有用于保护神经、组织和/或硬脑膜不被切断的非切割保护端(12),所述非切割保护端位于所述切割部的末端。 1. A surgical drill (1, 1 '), comprising a drill bit member (10), said drill element (10) has a cutting portion for cutting a bone (11, 11', 11 "), located at the cutting portion the distal end of the drill bit element, wherein said element having a drill bit for protecting nerves, tissue and / or dura mater is not cut non-cutting protective tip (12), said non-cutting protective tip is in the cutting portion end.
2. 根据权利要求i所述的手术钻头,其中,所述切割部具有第一外直径(d,), 所述非切割保护端具有第二外直径(d),所述第二外直径(d)小于所述切割部的第一外直径。 The surgical drill according to claim i, wherein the cutting unit (D,) having a first outer diameter, the non-cutting protective tip having a second outer diameter (D), said second outer diameter ( d) less than the first outer diameter of the cutting portion.
3. 根据权利要求2所述的手术钻头,其中,所述非切割保护端具有第二外直径(d),所述第二外直径(d)比所述切割部的第一外直径小1毫米至2毫米。 The surgical drill according to claim 2, wherein said non-cutting protective tip having a second outer diameter (d), said second outer diameter (d) smaller than the first outer diameter of the cutting portion 1 to 2 mm.
4. 根据前述任一项权利要求所述的手术钻头,其中,所述非切割保护端包括至少一个大致上的圆柱部(120)和至少一个位于所述大致上的圆柱部的远端的圆锥部(122)。 According to any of the preceding claims surgical drill bit, wherein the non-cutting protective cone includes a distal cylindrical end portion (120) and at least one substantially cylindrical portion located substantially in at least one of portion (122).
5. 根据权利要求4所述的手术钻头,其中,所述非切割保护端包括至少一个位于所述大致上的圆锥部的远端的大致上的球形部(124)。 5. The surgical drill according to claim 4, wherein said non-cutting protective cone includes a distal end portion of said at least one substantially positioned in a substantially spherical portion (124).
6. 根据前述任一项权利要求所述的手术钻头,其中,所述非切割保护端为钝面。 The surgical drill according to any of the preceding claims, wherein said non-cutting protective tip is a blunt surface.
7. 根据权利要求6所述的手术钻头,其中,所述非切割保护端包括至少一个经过抛光和/或光滑的表面部分,尤其是经过机械抛光的表面部分和/或经过电抛光的表面部分。 The surgical drill according to claim 6, wherein said non-cutting protective tip comprising at least one polished and / or smooth surface section, in particular through the mechanically polished surface portion and / or the surface portion of electropolished .
8. 根据前述任一项权利要求所述的手术钻头,其中,所述非切割保护端覆有光滑的涂层,尤其是质地平滑的涂层、低摩擦涂层和/或聚四氟乙烯涂层。 The surgical drill according to any of the preceding claims, wherein said non-cutting protective tip is coated with a smooth coating, in particular a coating texture was smooth, low friction coating and / or coated with Teflon Floor.
9. 根据前述任一项权利要求所述的手术钻头,其中,所述非切割保护端在远端方向的长度(l)至少为5毫米,优选为在5毫米和15毫米之间,最好是5毫米、或10毫米或15毫米。 9. A claim according to any preceding surgical drill bit, wherein the non-cutting protection tip length (l) in the distal direction at least 5 mm, preferably between 5 and 15 mm, preferably 5 mm, or 10 mm or 15 mm.
10. 根据前述任一项权利要求所述的手术钻头,其中,所述切割部具有与所述非切割保护端邻近的切割端面(110)。 10. The surgical drill according to any preceding claim, wherein the cutting portion has a non-cutting protective tip adjacent to said cutting face (110).
11. 根据前述任一项权利要求所述的手术钻头,其中,还包括具有套筒通道(20)的套筒(2),所述套筒通道(20)用于容纳所述钻头元件(10),使所述钻头元件(10)插入所述套筒时能够旋转。 11. The surgical drill according to any preceding claim, wherein further comprising a sleeve (2) having a sleeve channel (20) of the sleeve channel (20) for receiving the drill member (10 ), so that the drill bit element (10) is rotatable when inserted into the sleeve.
12. 根据权利要求11所述的手术钻头,其中,所述套筒在其近端有内螺紋(222),所述钻头元件在其近端有外螺紋(122),以便所述钻头元件可以通过钻头元件与所述套筒的相对旋转,而相对于所述套筒前进。 12. The surgical drill according to claim 11, wherein said sleeve having an internal thread (222) at its proximal end, said drill element having an external thread (122) at its proximal end, so that the drill member can by relative rotation of the drill bit and the sleeve member, relative to the sleeve forward.
13. 根据前述任一项权利要求所述的手术钻头,其中,所述钻头元件包括沿所述钻头元件的轴向延伸的引导通道(13),以^^导引线(4,)能够穿过所述钻头元件而插入所述引导通道中。 13. The surgical drill according to any preceding claim, wherein the drill member comprises a guide channel (13) extending axially along the drill bit member to ^^ guide wire (4) can be worn through the drill bit element is inserted into the guide channel.
14. 根据权利要求13所述的手术钻头,其中,所述引导通道从所述钻头元件的远端向所述钻头元件的近端延伸。 14. The surgical drill according to claim 13, wherein said guide passage extending from the distal end of the proximal end of the drill bit element to element.
15. 根据前述任一项权利要求所述的手术钻头,其中,所述切割部是钻孔锥、环钻、铣刀、铰刀或环锯(ll,ll")中的至少一种。 The surgical drill according to any preceding claim, wherein the cutting portion is a burr, a trephine, at least a milling cutter, a reamer or trephine (ll, ll ") of the.
16. 根据前述任一项权利要求所述的手术钻头,其中,所述切割部具有钻头螺紋(ll,)。 16. The surgical drill according to any preceding claim, wherein the cutting bit having a threaded portion (ll,).
17. 根据前述任一项权利要求所述的手术钻头,其中,在所述钻头元件的近端有手柄(15)、可拆卸的手柄和/或连接到机械钻的连接器。 17. The surgical drill according to any preceding claim, wherein the drill bit at the proximal end with a handle element (15), a removable handle and / or connected to a connector mechanically drilled.
18. —种手术钻头组,至少包括如前述任一项权利要求所述的一个第一手术钻头和一个第二手术钻头,所述第一手术钻头的切割部(ll)的外直径等于或大于所述第二手术钻头的非切割保护端(12)的外直径。 18. - group different surgical drill bit, including at least any of the preceding claims in a first surgical drill bit and a second operation, the outer diameter of the first surgical drill cutting portion (LL) is equal to or greater than non-cutting protective tip (12) of the second surgical drill outer diameter.
19. 根据权利要求18所述的手术钻头组,其中,所述第二手术钻头的所述非切割保护端的直径-使其能够插入所述第一手术钻头的切割部钻出的孔。 19. The set of surgical drills according to claim 18, wherein said second surgical drill of the non-cutting protection diameter end - it can be inserted into the hole portion of the first surgical drill cutting drilled.
20. 根据权利要求18或19所述的手术钻头组,其中,所述手术钻头组设置有多个手术钻头,所述多个钻头的切割部的直径(d,)分别为3毫米、4毫米、5 毫米、6毫米、7毫米、8毫米、9毫米、IO毫米、11毫米和12毫米,或分别为3.5亳米、4.5毫米、5.5亳米、6.5毫米、7.5毫米、8.5毫米、9.5毫米、10.5 亳米、11.5毫米和12.5毫米。 20. The surgical drill bit group 18 or claim 19, wherein said set of surgical drills is provided with a plurality of surgical drill, the diameters of the drill bit cutting portion (D,) each of 3 mm, 4 mm , 5 mm, 6 mm, 7 mm, 8 mm, 9 mm, the IO mm, 11 mm and 12 mm, respectively, or 3.5 millimeters, 4.5 millimeters, 5.5 millimeters, 6.5 mm, 7.5 mm, 8.5 mm, 9.5 mm , 10.5 millimeters, 11.5 millimeters and 12.5 millimeters.
21. 根据权利要求18或19所述的手术钻头組,其中,所述手术钻头组设置多个手术钻头,所述多个钻头的切割部的直径(d,)分别为4毫米、6毫米、8 毫米和10毫米,相应的所述非切割保护端的直径分别为2毫米、4毫米、6毫米和8亳米。 21. The surgical drill bit group 18 or claim 19, wherein said set of surgical drills is provided a plurality of surgical drill, the diameters of the drill bit cutting portion (D,) respectively 4 mm, 6 mm, 8 and 10 mm, the respective non-cutting protective tip diameters of 2 mm, 4 mm, 6 mm and 8 millimeters.
22. 根据权利要求18-21任意一项所述的手术钻头组,其中,所有手术钻头的所述非切割保护端的长度(l)都相等。 22. The set of surgical drills according to any one of claims 18-21, wherein all of the length of the protective non-cutting end of the bit operation (l) are equal.
23. 根据权利要求18-22任意一项所述的手术钻头组,其中,所述手术钻头有套筒,每一个在后的手术钻头的套筒都能够分别^:置在在前的手术钻头的套筒上。 23. The set of surgical drills according to any one of claims 18-22, wherein said surgical drill sleeve, each one surgical drill after the sleeve can be separately ^: surgery disposed in front of the drill bit on the sleeve.
24. —种手术钻头,包括钻头元件,所述钻头元件具有:切割部,用于切割骨骼,所述切割部位于所述钻头元件的远端;非切割保护端,用于保护神经、组织和/或硬脑膜不被切断,所述非切割保护端位于所述切割部的远端;所述切割部具有第一外直径,所述非切割保护端具有小于所述切割部的所述第一外直径的第二外直径。 24. - different surgical drill including a drill member, said drill element having: a cutting portion for cutting a bone, at a distal end portion of the cutting element of the drill bit; a non-cutting protective tip for protecting nerves, tissue and / or the dura mater is not cut, the non-cutting protective tip at the distal end of the cutting portion; said cutting portion having a first outer diameter, the protective non-cutting end of the cutting portion is less than the first the second outer diameter of the outer diameter.
25. 根据权利要求24所述的手术钻头,其包含权利要求3-17中至少一个的特征。 25. The surgical drill according to claim 24, comprising at least one of claims 3-17 characterized.
26. —种手术钻头,包括钻头元件,所述钻头元件具有: 切割部,用于切割骨骼,所述切割部位于所述钻头元件的远端;非切割保护端,用于保护神经、组织和/或硬脑膜不被切断,所述非切割保护端位于所述切割部的远端;引导通道,所述通道沿所述钻头元件的轴向延伸,以便导引线能够穿过所述钻头元件而插入所述引导通道。 26. - different surgical drill including a drill member, said drill element having: a cutting portion for cutting a bone, at a distal end portion of the cutting element of the drill bit; a non-cutting protective tip for protecting nerves, tissue and / or the dura mater is not cut, the non-cutting protective tip at the distal end of the cutting portion; guide channel, along said channel extending axially of the drill member to the guide wire can pass through the drill bit element It is inserted into said guide channel.
27. 根据权利要求26所述的手术钻头,其中,所述引导通道从所述钻头元件的远端向所述钻头元件的近端延伸。 27. The surgical drill according to claim 26, wherein said guide passage extending from the distal end of the proximal end of the drill bit element to element.
28. 根据权利要求26或27所述的手术钻头,其包含权利要求2-12和/或15-17至少一个的特;^正。 28. The surgical drill 26 or claim 27, comprising as claimed in claim / or at least 15-17 2-12 and a special; ^ n.
29. —种切割骨駱的系统,所述系统包括至少一个如权利要求l-17之一所述的手术钻头以及一个插入身体的工作插管(9)。 29. - Luo kind of cutting bone, the system comprising at least one l-17 surgical drill according to one of claims inserted into a body and a working cannula (9).
30. 根据权利要求29所述的系统,其中,所述系统还包括具有套针的针(3), 最好是规格18的针,用于定位身体骨骼的引导开口以及穿过所述针的洞而插入的导引线(4)。 30. The system according to claim 29, wherein said system further includes a needle with a trocar (3), preferably a needle gauge of 18, the positioning of the body opening for guiding the bone and through the needle a guide wire inserted hole (4).
31. 根据权利要求29或30所述的系统,其中,所述系统包括扩张杆(5), 用于扩张体内组织的通道。 31. The system of claim 29 or claim 30, wherein said system comprises expansion rod (5), the channel for expanding body tissue.
32. 根据权利要求29-31之一所述的系统,其中,所述系统还包括具有Yamshidi针,所述Yamshidi针包括Yamshidi套筒(7)、用于在骨骼中产生引导开口的Yamshidi套管针以及用于插入Yamshidi套筒的钻头(8)。 32. The system according to one of claims 29-31, wherein said system further comprises a Yamshidi needle with a Yamshidi needle comprises a Yamshidi sleeve (7), for generating a Yamshidi sleeve guide opening in the bone needle and a drill bit (8) for insertion into the Yamshidi sleeve.
33. 根据权利要求29-32之一所述的系统,其中,所述系统包括如权利要求18-23任一所述的手术钻头组。 33. The system according to one of claims 29-32, wherein said system comprises a surgical drill bit as set forth in claim any one of claims 18-23.
34. —种移除骨骼的方法,包括以下步骤:a. 将具有起始直径的引导通道(650)引入骨骼;b. 将包括切割元件(ll)的手术钻头(l)伸入所述引导通道,所述切割元件的切割直径大于所述起始直径,所述手术钻头在其远端具有直径等于或小于所述起始直径的非切割保护端(12),在钻孔前,将所述非切割保护端插入所述引导通道;C.将一系列切割直径逐渐增加的手术钻头分别伸入前一个手术钻头产生的通道(651),由于相应的所述非切割保护端的直径等于或小于所述前一个手术钻头的切割直径,因此所述非切割保护端插入由相应的前一个手术钻头的切割部产生的通道中。 34. - kind of bone removal method, comprising the steps of:.. A starting diameter having a guide passage (650) into the bone; B including a cutting element (LL) surgical drill (l) into said guide channel, the cutting element is a cutting diameter larger than the initial diameter, the surgical drill having a diameter equal to or less than the non-cutting protective tip (12) initial diameter at its distal end, prior to drilling the said non-cutting protective tip is inserted into said guide channel;. C prior to the passage of a series of gradually increasing diameter of the cutting operation extends into a surgical drill bit are generated (651), since the diameter of the respective non-cutting protective tip is equal to or less than the front of a surgical drill bit cutting diameter, and therefore the protective non-cutting end of the insertion portion cut from the respective front drill a surgically created channel.
35. 根据权利要求34所述的方法,其中,引导通道穿过各个骨骼的安全区, 尤其是与骨骼管相切,如与脊推管相切。 35. The method according to claim 34, wherein each guide channel through the safe area of ​​the bone, in particular tangential to a bone canal such as the ridge tangential push tube.
36. 根据权利要求34或35所述的方法,其中,通过使第一钻头,尤其是通过Yamshidi针的Yamshidi套筒(7),穿过关节嚢或肥大骨骼进入在神经条(硬脑膜)侧方的以及在分支和兴奋神经根的中心的脊推管的安全区来产生引导通道。 36. The method of claim 34 or claim 35, wherein the drill bit by the first, in particular by Yamshidi needle Yamshidi sleeve (7), through the joint into the bone or mast Nang nerve strip (dura) side side and in the secure area of ​​the center land of the push tube branching nerve roots and excitement to produce the guide channel.
37. 根据权利要求34-36之一所述的方法,其中,钻头进入病变的组织,例如推间盘突出部分、小关节或骨骼嚢肥大、滑液嚢肿或肿瘤。 37. A method according to any one of claims 34-36, wherein the drill bit into the diseased tissue, for example, the push portion herniation, facet hypertrophy Nang or bone, synovial fluid or tumor swelling Nang.
38. 根据权利要求34-37之一所述的方法,其中,手术钻头穿过所述引导通道而前进,所述手术钻头具有非切割保护端以及到所述保护部最远端的距离为10毫米至15毫米的切割部,所述切割部的外直径比所述非切割保护端的直径大1毫米至2毫米。 38. The method according to one of claims 34-37, wherein the surgical drill bit is advanced through the guide channel, the surgical drill having a non-cutting protective tip distance and the most distal portion 10 to the protection to 15 mm cutting portion, an outer diameter of the cutting portion is greater than 1-2 mm in diameter of said non-cutting protective tip.
39. 根据权利要求34-38之一所述的方法,其中,导引线伸入到所述引导通道,随后使用的器械由所述导引线引导。 39. The method according to any one of claims 34-38, wherein the guide wire extending into said guide channel, and then guided by the instrument used guidewire.
40. 根据权利要求39所述的方法,还包含以下步骤:将所述导引线插入在所述手术钻头的轴向延伸的引导通道中。 40. The method according to claim 39, further comprising the steps of: inserting the guide wire at the surgical drill guide channel extending axially.
41. 根据权利要求34-40之一所述的方法,其中,在骨骼中的引导通道产生之前,用于打开第一通道的针,最好是18规格针,穿过骨骼周围的组织而前进。 41. The method according to any one of claims 34-40, wherein, prior to generating the skeleton of the guide channel, the needle for opening the first passage, preferably 18 gauge needle through the tissue and bone surrounding the forward .
42. 根据权利要求41所述的方法,其中,导引线伸入到由所述针所打开的通道中。 42. The method according to claim 41, wherein the guide wire projects into the needle by the open channel.
43. 根据权利要求41或42所述的方法,其中,扩张杆(5)穿过由所述针所打开的通道中来扩张所述通道。 43. The method of claim 41 or claim 42, wherein the expansion member (5) by the needle passing through the opened passages to expand the passage.
44. 根据权利要求43所述的方法,其中,将套筒(2)伸入经过扩张的通道, 为第一手术钻头的前进提供通道。 44. The method according to claim 43, wherein the channel providing a sleeve (2) extends into the passage through the expansion for the first surgical drill forward.
CN 200680034944 2005-09-23 2006-09-22 A surgical drill, a set of surgical drills, a system for cutting bone CN101267774B (en)

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WO2007039141A8 (en) 2007-10-11
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